人类第6型疱疹病毒感染与特发性血小板减少性紫癜

探讨人类第６型疱疹病毒（ＨＨＶ－６）感染与特发性血小板减少性紫癜（ＩＴＰ）的关系。方法采用聚合栈 反应（ＰＣＲ）方法检测１０５例ＩＴＰ患者骨髓单个核细胞（ＢＭＭＮＣ）ＨＨＶ－６ＤＮＡ及部分患者微小病毒Ｂ１９、巨细胞病毒（ＨＣＭＶ）ＤＮＡ序列;用竞争性ＥＬＩＳＡ方法检测６６例ＩＴＰ患者血小板相关抗体（ＰＡＩｇ）,并采用间接免疫荧光法动态观察１９例ＩＴＰ患者抗ＨＨＶ－６血清抗体滴度变化。结果①ＩＴＰ患     

白细胞介素—6与急性髓系白血病相互关系的研究

急性髓系白血病（ＡＭＬ）细胞可具有高水平白细胞介素－６（ＩＬ－６）活性。ＩＬ－６可能在ＡＭＬ发病中具重要作用。抗ＩＬ－６单抗的初步临床应用为ＡＭＬ的治疗展示出良好的前景。     

老年急性白血病临床特征分析

目的：通过对３０例老年急性白血病患者的研究,了解老年急性白血病的临床特征与化疗效果及预后的关系。方法：选择自１９９８年７月～２０００年６月收治的３０例老年急性白血病（ＡＬ）患者,ＡＭＬ采用ＤＡ／ＨＡ方案;ＡＬＬ采用ＶＣＡＰ／ＶＣＤＰ方案;ＡＭＬＬ采用髓淋兼顾的ＶＣＡＡＰ方案。结果：完全缓解者１４例（４６．６％）,部分缓解３例,总有效率为５６．６％,３例治疗无效,死于并发症。结论：老年ＡＬ患者发病时     

急性髓系白血病细胞表面逆转录病毒抗体的测定

急性髓系白血病细胞表面逆转录病毒抗体的测定王跃华王世徐荣臻张克奇我们利用羊抗人ＩｇＧ－ＨＲＰ和制备的结合ＨＲＰ的纯化逆转录病毒（Ｒｅｔｒｏｖｉｒｕｓ，ＲＶ）抗原，采取直接酶免疫法，检测３７例急性髓系白血病（ＡＭＬ）细胞培养前后其表面特异性ＲＶ抗体的...     

血清可溶性L—选择素,sICAM—1,HBV DNA拷贝数及肝功能损害的相关性研究

目的 探讨Ｌ－ｓｅｌｅｃｔｉｎ（Ｌ－选择素）和ＩＣＡＭ－１（细胞间粘附分子－１）在乙型肝炎病毒感染造成肝功能损害过程中的作用。方法 定量检测４２例乙型肝炎病人血清ＨＢＶ ＤＮＡ拷贝数、可溶性Ｌ－选择素（ｓＬ－ｓｅｌｅｃｔｉｎ）、可溶性细胞产粘附分子－１（ｓＩＣＡＭ－１）及肝功能相关生化指标,并对结果进行统计分析。结果 ２２例ＤＮＡ阴性和２０例ＤＮＡ阳性病人血清ｓＬ－ｓｅｌｅｃｔｉｎ和ｓＩＣＡＭ－１水平均明显高于对照组（Ｐ〈０．０５）,但ＤＮＡ阴性组和阳性组之间的ｓＬ－ｓｅｌｅｃｔｉｎ和ｓＩＣＡＭ－１水平均无显著差异（Ｐ〉０．０５）;ＤＮＡ拷贝数与ｓＩＣＡＭ－１水平呈负相关（ｒ＝－０．５０１,Ｐ〈０．０５）;ＤＮＡ拷贝数与肝功能损害呈负相关;４２例乙肝病人的ｓＬ－ｓｅｌｅｃｔｉｎ和ｓＩＣＡＭ－１水平均与肝功能损害     

急性髓系白血病细胞侵袭能力与粘附分子表达关系探讨

目的：探讨白血病细胞浸润及转移与粘附分子表达的关系。方法：用免疫组织化学ＡＰＡＡＰ、免疫印迹方法研究５０例急性髓系白血病（ＡＭＬ）骨髓和（或）外周血白血病细胞粘附分子ＶＬＡ４（ＣＤ４９ｄ）、ＬＦＡ１（ＣＤ１１ａ）的表达。结果：发现ＡＭＬ浸润组ＣＤ４９ｄ、ＣＤ１１ａ表达较非浸润组显著增高（Ｐ＜０．００５）。结论：ＡＭＬ白血病细胞可能通过ＣＤ４９ｄ／ＶＣＡＭ－１，ＣＤ１１ａ／ＩＣＡＭ－１粘附机制与血管内皮细胞粘附而浸润组织。外周血白血病细胞与骨髓白血病细胞ＣＤ４９ｄ、ＣＤ１１ａ表达无显著差别，说明骨髓白血病细胞ＣＤ４９ｄ、ＣＤ１１ａ表达高低不是其从骨髓释出的唯一因素。     

AML病人的生活质量评估

ＡＭＬ病人的生活质量评估［英］／Ｓｔａｌｆｅｌｔ　ＡＭ／／ＬｅｕｋＲｅｓ．－１９９４，１８（４）．－２５７～２６６作者采用生活构成简介（ＬＩＰ）、Ｋａｒｎｏｆｓｋｙ生存质量计分（ＫＰＳ）及生命图三种不同的方法，对２７例急性骨髓性白血病（ＡＭＬ）病人的...     

恶性血液病患者血清可溶性白细胞介素6受体水平的研究

目的：探讨恶性血液病患者血清可溶性白细胞介素６受体（ｓＩＬ－６Ｒ）的临床价值。方法：采用酶联免疫法测定２６例多发性骨髓瘤（ＭＭ）、３４例急性白血病（ＡＬ）、１７例非霍奇金淋巴瘤（ＮＨＬ）患者化疗前后及正常献血员的血清ｓＩＬ－６Ｒ水平。结果：初诊时血清ｓＩＬ－６Ｒ水平，ＭＭ患者较正常对照组显著增高（Ｐ〈０．００１），Ｂ细胞系急性淋巴细胞白血病（Ｂ－ＡＬＬ）患者亦高于正常对照（Ｐ〈０．０１），急性淋巴     

中期荧光原位杂交在急性早幼粒细胞白血病诊断和微小残？…

为研究中期荧光原位杂交（Ｍ－ＦＩＳＨ）在急性早幼粒细胞白血病（ＡＰＬ）诊断及其微小残留病（ＭＲＤ）检测中的价值，应用１７号全染色体彩涂探针对１０例初诊时按细胞形态学诊断为急性髓细胞白血病（ＡＭＬ）的未治疗患（初治ＡＰＬ５例，复发ＡＰＬ３例，ＡＭＬ－Ｍ１和ＡＭＬ－Ｍ５各１例）和１０例治疗后获完全缓解（ＣＲ）的ＡＰＬ患作耻Ｍ－ＦＩＳＨ检测，并与常规细胞遗传学和逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）结     

白血病细胞膜相关因子（MAF－J6－1）单克隆抗体的制备及性质

用部分纯化的白血病细胞膜相关因子（ＭＡＦ－Ｊ６－１）对ＢＡＬＢ／Ｃ小鼠脾细胞进行体外免疫，然后与ＳＰ２／０小鼠骨髓瘤细胞融合获杂交瘤，经３次再克隆得到能产生ＭＡＦ－Ｊ６－１单克隆抗体（单抗）的杂交瘤细胞系。用ＡＢＣ免疫酶标法检测，该单抗在Ｊ６－１细胞上产生强阳性反应，并与ｒｈ－Ｍ－ＣＳＦ单抗对ＭＡＦ－Ｊ６－１及ｒｈ－Ｍ－ＣＳＦ产生交叉中和反应。ＭＡＦ－Ｊ６－１单抗还对Ｊ６－２、ＬＣＬ、Ｋ５６２等细胞系呈膜阳性反应，对白血病患者骨髓中部分原始和幼稚的单核、粒细胞呈阳性反应。在２４例被检测的白血病患者中，有三例呈强阳性反应，ＭＡＦ－Ｊ６－１可用作研究ｍ－Ｍ－ＣＳＦ与白血病关系的工具。     

人类疱疹病毒6型与造血紊乱初探

为探讨人类疤疹病毒6型(HHV-6)感染与造血紊乱的关系及对造血细胞移植受体的影响,用PCR法检测132例血液病患者骨髓单个核细胞(BMMNC)HHV-6 DNA特异序列,另对15例移植受体移植前后BMMNC HHV-6 DNA及血清抗HHV-6抗体滴度进行比较,并作病毒分离。结果表明,各组血液病患者的HHV-6 DNA阳性率不同。原发性血小板减少性紫癜(ITP)组和急性白血病(AL)组的阳性率明显高于其它组;移植后受体HHV-6 DNA阳性率及血清抗体滴度均较移植前升高,4例延迟植活患者中3例出现血清抗体滴度增长,1例移植失败患者移植后检出HHV-6 DNA,并出现脑炎症状。结论提示,HHV-6感染可能与ITP和AL相关。造血细胞移植受体移植后出现HHV-6的活化或感染可能与部分患者延迟植活有关。     

Elevation of HHV-6 viral load mimicking HHV-6 reactivation after second umbilical cord blood transplantation in chromosomally integrated human herpesvirus-6

Human herpesvirus-6 (HHV-6) reactivation is an important complication in patients receiving umbilical cord blood transplantation (CBT). Chromosomally integrated human herpesvirus-6 (ciHHV-6) is a condition in which the complete HHV-6 genome is integrated into the host germline genome and is transmitted in a Mendelian manner. The influence of ciHHV-6 in recipients or donors in cases of CBT is unknown. We report the first case with ciHHV-6 that received CBT twice for acute lymphoblastic T-cell leukemia. HHV-6 DNA in peripheral blood leukocytes (PBLs) was examined over time through two CBTs. After the first CBT, the HHV-6 viral load was significantly reduced by conversion to PBLs derived from the first donor. During the second CBT, an increase in HHV-6 DNA in PBLs and plasma were observed. However, HHV-6 mRNA was not detected in either the sample before 2nd CBT or at the time of HHV-6 DNA elevation. It is considered that the HHV-6 DNA detected in PBLs and plasma samples might be the HHV-6 genome released due to tissue damage. This case suggests that physicians should be aware of HHV-6 DNA variability during allogeneic hematopoietic stem cell transplantation in ciHHV-6 patients.     

73例慢性髓系白血病患者中IKAROS6表达研究

本研究旨在探讨慢性髓系白血病(CML)患者IKARO S6表达情况及其临床意义。采用PCR扩增产物克隆测序法检测73例CML患者中IKARO S6表达情况,了解IKARO S6阳性患者的临床特征。结果表明,在8例健康对照标本中未检测到IKARO S6表达,在15例CML慢性期和加速期标本中也均未检测到IKARO S6表达,42例急淋变的CML标本中15例(35.71%)表达IKARO S6,16例发生急髓变的CML标本中均未检测到IKARO S6表达;在42例急淋变的CML标本中:IKARO S6表达阳性的患者完全缓解(CR)率为40%(6/15例),显著低于IKARO S6表达阴性组(85.19%,23/27例)(p<0.01);IKARO S6表达阳性的患者缓解后15个月内(2-18个月)复发率66.7%(4/6例),显著高于IKARO S6表达阴性组(21.74%,5/23例)(p<0.05)。结论:IKARO S基因异常表达可见于CML进展为急性淋巴细胞白血病的患者,并以IKARO S6异构体为主。IKARO S基因异常表达可能是CML急变为ALL的一个重要因素和独立的预后指标。     

NK系白血病免疫表型特征

本研究目的是探讨NK细胞系白血病的的免疫表型。应用流式细胞术检测了297例急性白血病，并就发现的6例NK细胞系白血病病例分析其免疫表型特点。结果表明：297例急性白血病中CD56阳性43例，占14．5％，CD56阳性率21．4％～98．8％。43例中6例为NK细胞系白血病，其余37均为急性髓系白血病伴CD56表达；6例NK细胞系白血病中1例急性前髓系／NK细胞白血病（myeloid／NK cell precursor acute leukemia）；1例伴有早幼粒细胞样形态的急性髓系／NK细胞白血病；2例原始NK细胞白血病（blastic NK cell leukemia），1例NK样T细胞淋巴瘤／白血病（NK—like T—cell lymphoma／leukemia）；1例大颗粒淋巴细胞白血病。结论：伴CD56阳性急性白血病，绝大部分是急性髓系白血病伴CD56表达。NK细胞系白血病免疫表型各异，表现从多能造血干细胞经历髓系抗原阳性的T／NK双向祖细胞，分化为NK系祖细胞，再进一步分化为成熟NK细胞。对不同发育阶段的抗原表达特点．应仔细辨别，     

巢式MSP法检测急性白血病患者P16基因甲基化状态

为了研究p16基因甲基化和缺失与急性白血病发病的关系,探讨其在成人急性白血病发生发展中的生物学意义,应用巢式甲基化特异性聚合酶链反应（nested methylation specific polymerase chain reaction,n-MSP）分析了82例各种亚型的急性白血病患者在初诊或复发不同阶段p16基因的甲基化和缺失状态,并且在基因组硫化修饰PCR后克隆测序验证结果的准确性。结果表明：82例急性白血病（AL）患者p16基因甲基化的出现率为39.0%,其中急性髓系白血病（AML）患者为41.4%,24例急性淋巴细胞白血病（ALL）患者为33.3%;初治AL患者为36.6%,而复发患者则为54.5%。82例AL患者中有6例p16基因缺失,缺失率为7.3%,在AML、ALL患者中分别为1.7%和20.8%。16例健康自愿者或非恶性血液病患者p16基因则未发生甲基化或缺失。结论：在成人急性白血病的发生发展中,p16基因甲基化比p16基因纯合缺失更具有意义;p16基因表达异常与成人急性白血病的发生发展密切相关。     

Genotyping of the MTHFR gene polymorphism, C677T in patients with leukemia by melting curve analysis.

BACKGROUND: Methylenetetrahydrofolate reductase (MTHFR) plays a critical role in folate metabolism and displays common genetic polymorphisms affecting the enzyme activity. The MTHFR genetic polymorphisms have been associated with a decrease in the risk of developing the lymphoid but not myeloid form of pediatric and adult leukemias. AIM: In this study we describe the genotyping of the MTHFR C677T polymorphism by melting curve analysis with the LightCycler in a case-controlled study of patients with acute lymphocytic leukemia (ALL), myelogenous leukemia (AML), and chronic myelogenous leukemia (CML), and assess the effect of this common polymorphism on the leukemia risk in adult patients in Turkey. METHODS: DNA from peripheral blood lymphocytes was used for genotyping in the LightCycler PCR by melting curve analysis. The risk of leukemia associated with the MTHFR polymorphism was evaluated by comparing the genotype frequencies between the control and patient groups. RESULTS: The frequency of the homozygote variant genotype (677TT) was lower than that in healthy individuals in all three leukemia groups. The 677TT genotype did not appear to have a protective effect in patients with ALL (Odds ratio [OR] = 0.78 with a 95% confidence interval [CI] = 0.24-2.59), compared with healthy controls. The difference was higher (4.3-fold) in patients with AML, but still non-significant (OR = 0.23 with a 95% CI = 0.03-1.83). In patients with CML, the frequencies of both heterozygous (677CT) and homozygote variant genotypes were lower (OR = 0.72 and 0.66, respectively). CONCLUSIONS: Our results suggest that the MTHFR C677T polymorphism displays a similar distribution pattern in lymphoid and myeloid leukemias and that the frequency of the homozygote variant genotype (677TT) is lower in all leukemia types.     

Detection of the activating JAK2 V617F mutation in paraffin-embedded trephine bone marrow biopsies of patients with chronic myeloproliferative diseases

The discovery of the activating V617F mutation in the JAK2 tyrosine kinase in a high proportion of patients with Ph- chronic myeloproliferative diseases (CMPD) represents a diagnostic breakthrough for these disorders. Trephine bone marrow biopsy is an essential part of the diagnostic workup of CMPD and represents a valuable archival source of DNA. Therefore, we studied 152 paraffin-embedded trephines with CMPD and related disorders for the presence of the V617F mutation, using both allele-specific polymerase chain reaction (PCR) and nested PCR with subsequent digestion with BsaXI. Only 6 of 152 (4%) samples were not evaluable because of poor DNA quality. The V617F mutation was detected in 27 of 28 (96%) cases of polycythemia vera, 17 of 23 (74%) cases of essential thrombocythemia, 28 of 45 (62%) cases of chronic idiopathic myelofibrosis, six of eight (75%) cases of CMPD unclassified, and two of four (50%) cases of myelodysplastic/myeloproliferative syndrome. Ph+ chronic myelogenous leukemia (four cases), reactive (secondary) erythrocytosis (14 cases), and thrombocytosis (one case) as well as normal controls (19 cases) all lacked the V617F mutation. Based on results of BsaXI digestion and sequencing, 24 of 54 (44%) evaluable V617F+ cases were considered homozygously mutated. Thus, detection of the V617F JAK2 mutation is feasible in paraffin-embedded trephine biopsies and represents a major advance in the diagnostic evaluation of CMPD.     

Subtype-specific, probe-based, real-time PCR for detection and typing of human herpesvirus-6 encephalitis from pediatric patients under the age of 2 years

To investigate the frequency of human herpesvirus-6 (HHV-6) encephalitis in pediatric patients under 2 years of age, we developed a method for the simultaneous detection and differentiation of the 2 variants of HHV-6 (HHV-6A and HHV-6B) using subtype-specific, probe-based, real-time PCR (SSPBRT-PCR) and which were further evaluated on 405 cerebrospinal fluid (CSF) specimens from children with suspected encephalitis. A total of 23 (5.70%) out of 405 CSF specimens were positive by SSPBRT-PCR, including 3 cases of HHV-6A and 20 cases of HHV-6B. The positive rate of HHV-6B was significantly higher than that of HHV-6A (P = 0.0004). Compared with the results of the conventional real-time PCR, the sensitivity and specificity of the SSPBRT-PCR assay were 95.24% and 99.22%, respectively. This study suggests a role for both variants of HHV-6 in the pathogenesis of viral encephalitis. SSPBRT-PCR can provide rapid, sensitive, and specific results for identification of HHV-6A and HHV-6B and management of HHV-6 encephalitis.     

同源盒基因HoxA10在急性白血病中的表达及相关研究

本研究探讨HoxA10基因在急性白血病患者中的表达及其临床意义.运用逆转录-聚合酶链反应（RT-PCR）方法,检测50例急性白血病患者和10例对照者（7例正常人、3例ITP）中HoxA10mRNA的表达水平;分析其在急性白血病中的表达规律及与临床预后的关系.结果表明：HoxA1o在各型急性髓系白血病中均表达,在急性淋巴细胞白血病和部分对照者中低表达.3例正常人不表达HoxA10.HoxA10 mRNA表达水平在急性髓系白血病明显高于急性淋巴细胞白血病患者和对照组（P＜0.01）,在急性髓系白血病中,M1型和M2型表达水平高于M4型和M5型,在M3型有显著高表达.骨髓中原、幼细胞比例和HoxA10mRNA表达水平呈正相关关系（r=0.635,P＜0.01）.未缓解组9例患者HoxA10表达水平高于缓解组8例患者,但无显著差异（P=0.258）.1例M2患者和1例M5患者缓解后HoxA10不表达.结论：HoxA10在急性髓系白血病中有异常高表达,具有髓系特异性,可作为区别淋系和髓系的标志性基因,但不是肿瘤细胞特有的基因,而是一类调控造血的转录因子,能与多种协同因子共同影响白血病的发生和发展.HoxA10的表达水平与肿瘤细胞负荷有关,与急性白血病的疗效有一定关系.